Furukawa K, Higuchi S, Ueno T, Suda H, Natsuaki M, Itoh T
Department of Thoracic and Cardiovascular Surgery, Saga Medical School, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Jun;44(6):826-9.
Now, the standard operation for a case with AAE and AR is the composite graft replacement. In this case, an aortic valve sparing aortic root reconstruction, the so-called David's operation, and the intraoperative endoscopic study were performed. In the case of 68-year-old male with AAE and AR, the aortic valve was reimplanted in a tubular Dacron graft and coronary arteries were reconstructed with the Carrel patch technique. After the completion of the aortic root reconstruction, intraoperative endoscopic study revealed the disappearance of AR. Postoperative aortography revealed trivial AR and at present, seven months postoperatively, this patient have been uneventful. In this paper, we discuss the merits and demerits of the David's operation and the effectiveness of intraoperative endoscopic study for the aortic valve sparing operation.
目前，AAE和AR病例的标准手术是复合移植物置换。在本病例中，进行了保留主动脉瓣的主动脉根部重建术，即所谓的大卫手术，以及术中内镜检查。对于一名68岁患有AAE和AR的男性患者，将主动脉瓣重新植入涤纶人工血管中，并用卡雷尔补片技术重建冠状动脉。主动脉根部重建完成后，术中内镜检查显示AR消失。术后主动脉造影显示微量AR，目前术后七个月，该患者情况良好。在本文中，我们讨论了大卫手术的优缺点以及术中内镜检查对保留主动脉瓣手术的有效性。
